Although progress has been made toward achieving the Healthy People 2010 immunization objectives, pockets of undervaccinated children remain throughout the United States, especially those living in urban areas. The failure of parents or providers to recognize that a child is due (or overdue) for vaccinations is a persistent problem and an important underlying cause of inadequate vaccination. In response, the past decade has witnessed unprecedented growth of immunization registries which track immunization records and assess vaccination status. Most immunization registries are also capable of generating individualized notices for children that require vaccinations. Notification may be made by mail, telephone or computer to either encourage appointments for upcoming scheduled vaccinations (reminders) or those doses that are overdue (recalls). There is ample evidence demonstrating the effectiveness of immunization reminder/recall. An important barrier to achieving the full potential of registry-based reminder / recall systems is the accuracy and completeness of parents' contact information. Without accurate contact information, mailed reminder/ recall notices cannot be delivered to the appropriate parties and telephone messages cannot reach the intended recipients. Prior reports indicate that failures to contact parents with mail or telephone reminder/recall notices are commonplace. The proposed study will develop and evaluate innovative approaches to successfully contact parents regarding the specific immunizations their child needs. The specific aims of the Innovations to Improve Successful Contact of Parents for Immunization Reminders program are to: (1) describe the methods currently used by a statewide immunization registry to update parent contact information; (2) evaluate the effectiveness and usefulness of existing registry data in contacting parents; (3) identify new strategies for generating and updating parent contact information; (4) identify innovative strategies to contact parents of children in the registry who cannot be contacted by mail or telephone; (5) evaluate the effectiveness and usefulness of new strategies in terms of both successful parent contact and changes in vaccination status; and (6) evaluate the cost-effectiveness of new strategies. The proposed study is unique in that it focuses on the experiences of one of the nation's largest and most advanced statewide immunization registries. We will explore a broad array of existing information systems as potential new sources of parent contact information as well as the most effective means to successfully update immunization registry data. For those individuals that cannot be reliably contacted through mail or telephone notices, we will develop and test new contact methods targeted to "unreachable" populations. Results of the study will serve to inform efforts in other states and communities to improve parent contact information in immunization registries. Immunization registries are useful mechanisms to conduct immunization reminder/recall; however, inaccurate parent contact information limits the effectiveness of registries for this purpose. This project will develop and evaluate different strategies to improve the parent contact information included in a state immunization registry. [unreadable] [unreadable] [unreadable]